Nursing
You are a nursing manager of the education and innovations department at a large nonprofit academic medical center. You do work at the flagship hospital, but there are three additional campuses and several affiliated facilities throughout three additional states. Therefore, technology is heavily relied upon for consistent and reliable communication for interdisciplinary care. Recently, the CNO sent you a patient satisfaction survey highlighting how impressed this patient was with their nurse’s timeliness of answering their questions. The patient continued to share that the nurse used their personal cell phone to reach out to the patient’s provider to get clarification of the patient’s discharge instructions. The patient loved their quick response and wanted to highlight this as a best practice for all healthcare professionals.
Instructions
You have just completed a technology usage assessment of the healthcare staff across departments, and it has come to your attention that several nurses occasionally communicate with medical providers through text on their personal cell phones, using their phone’s messaging service. The nurses found that they are able to meet their patient needs more quickly. Your assessment also discovered that a nurse used their personal cell phone to take a picture of a patient’s foot ulcer. The picture was posted on social media as a reminder to diabetics the importance of managing their blood sugars. As the nursing education manager it is your responsibility to ensure staff are following the hospital polices and your technology assessment has highlighted that the staff is in urgent need of HIPAA training and Smart Phone use.
Using the scenario above create a mandatory training for all staff using PowerPoint with voice over including the following:
Examine personal Smart Phone use and its implications in Healthcare
Identify and explain a minimum of 3 unethical uses of Smartphones in healthcare (including text messaging and pictures)
Discuss potential benefits to appropriate Smartphone use in healthcare
Examine judicious use of Social Media and its implications in Healthcare
Potential benefits to appropriate use of Social Media in healthcare
Identify a minimum of 3 unethical uses of Social Media (as reviewed by NCSBN)
Describe regulatory bodies and Ethical Frameworks used to protect Personal Health Information (PHI)
Investigate the role of HIPAA, HITECH, and Nursing Code of Ethics
Determine the legal consequences associated with unethical or illegal Smart Phone and Social Media use.
Qualitative Annotated Bibliography
For this assignment you will continue to review current research from South’s Online Library and provide a critical evaluation on that research through an annotated bibliography. An annotated bibliography is a brief summary and analysis of the journal article reviewed. For more information on annotated bibliographies please visit Purdue’s OWL: Purdue Online Writing Lab
A total of two annotated bibliographies are to be submitted (not to exceed one page each). The articles must come from nursing scholarly literature and may not be older than 5 years since publication. Please note that the articles must be research based and reflect a qualitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable.
Each annotation must address the following critical elements:
Explanation of the main purpose and scope of the cited work
Brief description of the research conducted
Value and significance of the work (e.g., study’s findings, scope of the research project) as a contribution to the subject under consideration
Possible shortcomings or bias in the work
Conclusions or observations reached by the author
Summary as to why this research lends evidence to support the potential problem identified specific to your role specialization.
Submissions Area:
Please submit to the Submissions Area by the due date assigned.",######$$$$$$$$$##########
Help Needed for Essay Writing - 500 words,"Describe what distinguishes your passion for nursing and identify the three most important attributes of an exemplary nurse. Explain how you will demonstrate these attributes throughout the remainder of your training and career.
(A Scholarship Essay for a nursing school for my career as an intensive/critical care nurse)
Where in the World Is Evidence-Based Practice?
March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.
When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.
In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.
Review the Resources and reflect on the definition and goal of EBP.
Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
Explore the website to determine where and to what extent EBP is evident.
Question
Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples
The Evidence-Nursing Practice Connection
Purpose
This week's graded topics relate to the following Course Outcome (CO).
CO 1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7)
CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8)
Discussion
Improving patient care and outcomes is paramount to the practice of nursing. As we conclude our learning journey through our world of research and evidence-based practice, it is important to reflect upon your time spent in the course:
Think about nursing practice and describe one barrier that you feel prohibits nurses from engaging in EBP; share one strategy you could use to facilitate the use of evidence to help improve nursing care for patients.
Reflect back over your time in the course and describe how your thinking has changed about nursing research and evidence-based practice; describe one new learning during this course that you believe was the most helpful.
Pharmacokinetics and Pharmacodynamics
Explain the role of the community health nurse in partnership with community stakeholders for population health promotion. Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion.
REFERENCES
Read Chapter 1 in Community and Public Health: The Future of Health Care.
URL:https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/community-and-public-health_the-future-of-health-care_1e.php
Explore the American Public Health Association (APHA) website.
URL:https://www.apha.org/
T1DQ2. BY 2/27.
250 WORDS CITATION AND REFERENCES
Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population
Study case
I’m here for a medication refill because I ran out of my medicines”.
HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH: Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies: Penicillin
Vaccination History: Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden's nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH: Normal affect. Cooperative. SKIN: No rashes. Positive for dry skin.
Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.
A:
Primary Diagnosis: Congestive Heart Failure (CHF)
Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA)
Differential Diagnosis: Peripheral Vascular Disease (PVD)
Plan:
Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain
Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index.
Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 %
BNP – not available.
As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease).
Questions:
1. According to the ACC/AHA guidelines, what medications should this patient be prescribed?
2. Does he need medication(s) given his history of MI?
Posts must be supported by at least 2 peer reviewed references and all paragraphs must be cited. APA 6th
Agenda Comparison Grids
Agenda Comparison Grids
(With at least 2 paragraphs with 3 references which must be at least 5 yeast old with in text citations. )
Info:
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
In Part 1 of this module’s Assignment, you were asked to begin work on an Agenda Comparison Grid to compare the impact of the current/sitting U.S. president and the two previous presidents’ agendas on the healthcare item you selected for study. In this Discussion, you will share your first draft with your colleagues to receive feedback to be applied to your final version.
To Prepare:
· Review the Resources and reflect on the importance of agenda setting.
· Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities. Needed by Tuesday 25, 2020
Presidents are:
Trump
Obama
George W Bush
Issue of Quality and Safety
1. In the last century, what historical, social, political, and economic trends and issues have influenced today’s health-care system?
2. What is the purpose and process of evaluating the three aspects of health care: structure, process, and outcome?
3. How does technology improve patient outcomes and the health-care system?
4. How can you intervene to improve quality of care and safety within the health-care system and at the bedside?
2. Select one nonprofit organization or one government agencies that influences and advocates for quality improvement in the health-care system. Explore the Web site for your selected organization/agency and answer the following questions: •
What does the organization/agency do that supports the hallmarks of quality? •
What have been the results of their efforts for patients, facilities, the health-care delivery system, or the nursing profession? •
How has the organization/agency affected facilities where you are practicing and your own professional practice?
Discussion Board
I’m here for a medication refill because I ran out of my medicines”.
HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH: Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies: Penicillin
Vaccination History: Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden's nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH: Normal affect. Cooperative. SKIN: No rashes. Positive for dry skin.
Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.
A:
Primary Diagnosis: Congestive Heart Failure (CHF)
Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA)
Differential Diagnosis: Peripheral Vascular Disease (PVD)
Plan:
Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain
Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index.
Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 %
BNP – not available.
As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease).
Questions:
1. According to the ACC/AHA guidelines, what medications should this patient be prescribed?
2. Does he need medication(s) given his history of MI?
Chronic Stable Angina
Use APA 6th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers. All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 4 pages, excluding cover page and reference page.
E.H. is a 45-year-old African American man who recently moved to the community from another state. He requests renewal of a prescription for a calcium channel blocker, prescribed by a physician in the former state. He is unemployed and lives with a woman, their son, and the woman’s 2 children. His past medical history is remarkable for asthma and six “heart attacks” that he claims occurred because of a 25-year history of drug use (primarily cocaine). He states that he used drugs as recently as 2 weeks ago. He does not have any prior medical records with him. He claims that he has been having occasional periods of chest pain. He is unable to report the duration or pattern of the pain. Before proceeding, explore the following questions: What further information would you need to diagnose angina (substantiate your answer)? What is the connection between cocaine use and angina? Identify at least three tests that you would order to diagnose angina.
Diagnosis: Angina
1. List specific goals of treatment for E.H.
2. What dietary and lifestyle changes should be recommended for this patient?
3. What drug therapy would you prescribe for E.H. and why?
4. How would you monitor for success in E.H.?
5. Describe one or two drug–drug or drug–food interactions for the selected agent.
6. List one or two adverse reactions for the selected agent that would cause you to change therapy.
7. What would be the choice for the second-line therapy?
8. Discuss specific patient education based on the prescribed first-line therapy.
9. What over-the-counter and/or alternative medications would be appropriate for E.H.?
